The diagnostic value of 1.5-T diffusion-weighted MR imaging in detecting 5 to 10 mm metastatic cervical lymph nodes of nasopharyngeal carcinoma.

The aim of the study was to prospectively assess the diagnostic accuracy of 1.5 T diffusion-weighted imaging (DWI) for 5 to 10 mm metastatic cervical lymph nodes of patients with nasopharyngeal carcinoma (NPC). All patients with histopathologically confirmed NPC underwent DWI with 2 b values of 0 and 800 s/mm were enrolled. The shortest axial diameter and mean apparent diffusion coefficient (ADC) value were recorded when lymph nodes with a shortest axial diameter from 5 to 10 mm were measured. The correlation between the pathological diagnoses and mean ADC values in the benign and metastatic lymph nodes were compared using the Z test. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic performance of DWI. Three hundred fourteen nodes of 52 patients with NPC consisted of 46.5% (146/314) metastatic lymph nodes and 53.5% (168/314) benign lymph nodes. The mean ADC value (×10 mm/s) of benign lymph nodes was (1.110 ±â€Š0.202), which was significantly higher than that of metastatic nodes (0.878 ±â€Š0.159) (P < 0.05). The sensitivity, specificity, positive predictive value, and negative predictive value, accuracy for differentiating metastatic from benign lymph nodes using a cutoff ADC value of 0.924 × 10 mm/s was 83.56%, 82.74%, 80.79%, 85.28%, and 82.80%, respectively. The area under the ROC curve was 0.851 (95% confidence intervals: 0.807-0.889). This study demonstrated that DWI is helpful in detecting 5 to 10 mm metastatic lymph nodes of patients with NPC.

[Relationship between expression of decoy receptor 3 and apoptosis in hepatocellular carcinoma].

OBJECTIVE: To study the expression of decoy receptor 3 (DcR3) and its relationship with apoptosis and prognosis in hepatocellular carcinoma (HCC). METHODS: The expression of DcR3 protein in 43 cases of HCC and 16 cases of non-cancerous liver (including cirrhotic liver tissue and normal liver tissue adjacent to cavernous hemangioma) was studied by immunohistochemistry (using EnVision method). The status of apoptosis was evaluated by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) technique. Statistic analysis was carried out to assess the correlation between DcR3 expression, apoptotic index (AI) and clinicopathologic parameters. RESULTS: DcR3 protein was expressed in the cytoplasm of HCC cells. The positivity rate of DcR3 in HCC was 74.42% (32/43), which was significantly higher than that in the non-cancerous group (43.75%, P < 0.05). The positivity rate of DcR3 in HCC with metastasis detected within 20 months of diagnosis was 100% (22/22). This was significantly higher than that in HCC without metastasis (52.94%, P < 0.01). The DcR3 expression in HCC also correlated with serum alpha-fetoprotein level (r = 0.444, P < 0.01) and presence of tumor embolus in portal vein (r = 0.414, P < 0.01). However it had no relationship with the patient's age, sex, cirrhotic status, liver capsule invasion, number of tumor nodules and histologic differentiation (P > 0.05). The AI in HCC (0.78 +/- 0.64)% was significantly lower than that in the non-cancerous group [(3.32 +/- 1.81)%, P < 0.01]. The AI in clinical TNM stage I and II tumors (1.03 +/- 0.69)% was significantly higher than that in stage III and IV tumors [(0.52 +/- 0.48)%, P < 0.01]. The AI in HCC without metastasis (1.10 +/- 0.72)% was significantly higher than that in HCC without metastasis [(0.44 +/- 0.27)%, P < 0.05]. The AI correlated with serum alpha-fetoprotein level (r = -0.468, P < 0.01), presence of tumor embolus in portal vein (r = -0.434, P < 0.01) and liver capsule invasion (r = -0.331, P < 0.05). On the other hand, it had no relationship with patient's age, sex, cirrhotic status, number of tumor nodules and histologic differentiation (P > 0.05). The AI in DcR3-positive group (including both HCC and non-cancerous tissues) was significantly lower than that in DcR3-negative group (P < 0.01). CONCLUSIONS: The expression of DcR3 in HCC correlates with apoptosis of tumor cells and may play a crucial role in tumor pathogenesis and progression. DcR3 protein expression and AI may also serve as important biologic indicators in predicting prognosis of HCC.

[Expression of DeltaNp63 protein in nasopharyngeal carcinoma and its significance].

BACKGROUND & OBJECTIVE: The molecular etiology of nasopharyngeal carcinoma is currently unknown. It was reported that DeltaNp63 is dominant-negative toward transactivation of p53, and associated with the malignant hyperplasia and dedifferentiation of the squamous cells. This study was designed to investigate the expression and significance of DeltaNp63 protein in NPC tissues. METHODS: Immunohistochemical method was used to determine the expression of DeltaNp63 in 60 cases of NPC, 37 cases of nearby mucosa of the carcinoma, and 30 cases of chronic inflammation of nasopharyngeal mucosa. The classification of the 60 NPC cases were as follows: 3 cases of keratinizing squamous cell carcinomas, 57 cases of nonkeratinizing carcinomas including 12 cases of undifferentiated carcinomas. RESULTS: All 60 NPC cases showed DeltaNp63 positive reaction. Keratinizing squamous cell carcinomas showed weakly positive expression; 66.67% (38/57) of nonkeratinizing carcinomas showed strongly positive reaction, and 83.33% (10/12) of undifferentiated carcinomas showed strongly positive reaction. Chronic inflammation mucosas and cancer nearby mucosas showed positive reaction only in their basal and superbasal cells. CONCLUSION: DeltaNp63 protein was found to be closely associated with cell malignant hyperplasia. DeltaNp63 protein has distinct tendency to the infantile or anaplastic squamous cells, and DeltaNp63 protein is a valuable diagnostic marker for anaplastic squamous cells.